血管紧张素转换酶ACE基因I/D多态性与心衰患者抗阻运动效果的关联研究

Association of ACE Gene I/D Polymorphism and Effects of Resistance Exercise on Patients of Heart Failure

将96名慢性心力衰竭(CHF)患者随机分为运动组和对照组,每组再按照血管紧张素转换酶(ACE)基因插入、缺失多态性分为II、ID和DD三种基因型.运动组进行为期8周的抗阻运动处方干预,对照组保持日常生活习惯不变.实验前后利用递增负荷功率车测定最大摄氧量(VO2max)和最大功率,利用等速肌力测试仪测定右腿股四头肌的最大力量和力量耐力.结果显示,所选实验对象基因型分布频率(II:25.8%,ID:44.1%,DD:30.1%)符合H-W遗传平衡定律(P>0.05),具有群体代表性.实验前,ACE-ID基因型和DD基因型最大功率和VO2max低于II基因型(P<0.01);股四头肌最大力量和力量耐力在各基因型组间均无显著性差异(P>0.05).抗阻运动后,组内比较,运动组ACE-ID基因型和DD基因型最大功率和股四头肌力量耐力的变化值均高于II基因型(P<0.01);组间比较,运动组ID基因型和DD基因型最大功率和股四头肌力量耐力的变化值均高于对照组(P<0.01).对照组各指标在各基因型间无显著性差异(P>0.05).以上结果表明,CHF患者运动耐力以及抗阻运动后的干预效果与ACE基因I/D多态性存在关联,其中II基因型患者运动耐力高于D等位基因患者(DD和ID基因型),而D等位基因患者对抗阻训练的效果较II基因型更为敏感.

Ninety-six chronic heart failure （CHF） patients were randomly divided into exercise group and control group.Each group was subdivided into Ⅱ,ID and DD subgroup according to angiotensin converting enzyme （ACE） genotype.Subjects of exercise group performed an eight week resistance exercise while those of control group maintained their normal activities of daily living.Maximal oxygen uptake （VO2max） and peak power by graded bicycle ergometer test,and quadriceps femoris muscle maximal strength and endurance by isokinetic dynamometer were determined before and after the experiment.The results displayed that the genotype frequencies （II：25.8％,ID：44.1％,DD：30.1％） were coincident with Hardy-Weinberg equilibrium （P ＞0.05）.Before test at baseline,patients who were homozygous for the I allele had higher VO2max and peak power compared to patients who were homozygous for the D allele （P＜0.01）,while quadriceps femoris muscle maximal strength and endurance had no difference between each genotype group （P＞0.05）.After test,patients with the D allele,who were randomised to resistance training,compared to non-exercising controls,had greater peak power and quadriceps femoris muscle endurance increases （P ＜0.01） when compared with patients homozygous for the I allele and those of control group.All the indexes in control group showed no significant differences （P＞0.05）.Above data suggested that the I/D polymorphism of ACE gene might contribute to exercise tolerances and effectiveness of resistance exercise on CHF.Exercise tolerances of Ⅱ genotype patients were higher than those of D allele （DD and ID genotype）,while the effectiveness of resistance exercise of D allele patients had an advantage over that of Ⅱ genotype.